Laura Kohn Wood Glenetta Hudson Erin T Graham

The Surgeon General's report on mental health (U.S. Department of Health and Human Services, 1999) detailed the efficacy of available treatments for mental disorders in the United States. Cognitive therapy (CT) and cognitive-behavioral therapy (CBT) approaches to the treatment of major mood and anxiety disorders show particularly favorable outcomes in comparison to other psychotherapy and psychopharmacological interventions (for review see the Special Section of the Journal of Consulting and Clinical Psychology, February, 1998). However, a major finding from the supplement to the Surgeon General's report on culture, ethnicity and mental health (U.S. Department of Health and Human Services, 2001) was the lack of information regarding treatment outcomes for ethnic/minority populations. Previously, researchers have highlighted the need to include ethnic/minority populations in psychotherapy research and have provided recommendations to increase their inclusion in research trials. Despite these attempts, studies of empirically validated treatment approaches have typically not included ethnic/minority groups; therefore, little is known regarding the diverse applicability of existing interventions, including CT (Hall, 2001).

A related issue is the underutilization of mental health services by ethnic/minority populations (Snowden & Yamada, 2005). Researchers have suggested that numerous instrumental and perceptual barriers preclude therapy involvement for ethnic minorities (U.S. Department of Health and Human Services, 2001). Specifically, underutilization among Latinos has been attributed to inaccessibility, lack of services, and cultural acceptability (Hohmann & Parron, 1996). With few ethnic minorities participating in treatment and little information regarding the efficacy of existing treatments across ethnicity, mental health practitioners and researchers face a quandary. Can empirically validated treatment approaches such as CT generalize to ethnic/minority patients? Should CT or other approaches be culturally adapted, and if so, how?

In this chapter we discuss the conceptualization and assessment of depression, offer treatment recommendations, and examine the current literature regarding CT treatment outcomes for ethnic/minority groups in an attempt to answer these questions and synthesize available information to fill gaps in our knowledge. We focus on CT for depression in African Americans and Latinos, because research to date on adapting CT for depression in other minority groups, such as Asian Americans, has been limited. We use the term "ethnic minorities" and "ethnicity" to describe both African Americans and Latinos; however, we recognize that based on the U.S. Bureau of the Census distinctions, "African American" represents a racial group and "Latino" represents an ethnic group. Existing treatment studies of adult CT and CBT for mood disorders are reviewed. Increasing our understanding of treatment for African American and Latino groups is critical as we face an increasingly ethnically diverse population. We need to expand our ability to provide efficacious mental health services that will be widely utilized.

This guide Don't Panic has tips and additional information on what you should do when you are experiencing an anxiety or panic attack. With so much going on in the world today with taking care of your family, working full time, dealing with office politics and other things, you could experience a serious meltdown. All of these things could at one point cause you to stress out and snap.